2017-18 - OTA QUEENSLAND BUDGET REVIEW The Bottom Line The Palaszczuk Government s third budget is focussed squarely on an election likely to be called by year s end. There is a hefty commitment to big ticket infrastructure projects, all supporting the Labor Government s stated aim of cutting an unemployment rate stuck stubbornly around 6 per cent. Queensland s Government will spend more than $10 billion on capital works in 2017-18, which it hopes will generate 40,000 jobs. Chief among its projects is Brisbane s Cross River Rail project, with funding of $1.95 billion made available for the commencement of construction by the end of this year. While half of the funding for infrastructure projects will be spent in regional and remote areas, this investment is unashamedly skewed in favour of marginal seats that the Labor Party must hold if it is to retain office. A coal royalties windfall, amounting to a surplus of $2.8 billion in 2016-17, has been offset by the devastation of Cyclone Debbie, resulting in modest surpluses of $146 million in 2017-18 and $117 million in 2018-19. In all, it is forecast that Debbie represents a $2 billion economic hit. State Government debt stands at $33.8 billion in 2017-18. But despite a so-called debt action plan, this figure will rise to $81 billion by 2020-21, with Treasurer Curtis Pitt conceding that the coveted AAA credit rating will not be regained in the near future. Mr Pitt has again borrowed from State Government instrumentalities to fund the business of government, a situation unlikely to change while the state s public service continues to grow. This year public service salaries will account for more than 40 per cent of the government s spend. Economic growth of 2.75 per cent is forecast for next year, rising to 3 per cent in 2018-19. Overseas exports are forecast to grow between 3 to 4 per cent a year. There are numerous initiatives of direct relevance to occupational therapists working in Queensland. The total health budget in 2017-18 is $16.6 billion. This includes a $916 million investment in health facilities and infrastructure. There is also some investment in services for the aged and in mental health. Health infrastructure The Budget provides $916 million for health facilities and infrastructure. This includes significant investment in health infrastructure in rural, regional and remote parts of Queensland. Major projects include: $19.6 million over two years to expand Caboolture Hospital emergency department; $112.2 million over four years for detailed planning and preparatory works for redevelopments at Logan, Caboolture and Ipswich hospitals to increase capacity to deal with growth; $10 million in 2017-18 to expand Maryborough Hospital emergency department and refurbish the specialist outpatients department;
$138.2 million over four years for mental health infrastructure in South East Queensland and Cairns; $128.4 million over four years to redevelop or replace Kingaroy, Blackall and Sarina Hospitals, fit-outs of Townsville Hospital s breast-screen clinic and clinical services, the replacement of the Mer (Murray Island) primary healthcare centre clinical building, and upgrades to staff accommodation across Queensland. Mental health The Queensland Government has made a significant investment in youth mental health in this year s Budget. More than $68 million in additional funds have been provided to rebuild and expand mental health services for young people. The Budget provides additional capital funding of $138.2 million over four years to: Establish a new Adolescent Extended Treatment Facility on the Prince Charles Hospital site; Establish two new adolescent Step Up Step Down units in Brisbane; Refurbish two adolescent day program spaces at Logan and the Gold Coast; Establish a new holistic mental health unit at the Cairns Hospital. The State Government will continue to roll out its Connecting Care to Recovery 2016-2021 strategy, including $4.6 million for a Mental Health Maternal and Baby Unit and $2 million for a Mental Health Older Persons Unit at Gold Coast University Hospital. Initiatives delivered through this strategy provide comprehensive, high quality and safe recovery-oriented mental health, alcohol and other drug services. The Budget also supports the continuation of the Suicide Prevention in Health Services Initiative, which has supported the establishment of a Suicide Prevention Health Taskforce to support clinicians and staff to recognise and provide appropriate care to people at risk of suicide. The Taskforce is a partnership between the Department of Health, Hospital and Health Services and Primary Health Networks. Ageing Queensland members should note that aged care is primarily funded by the Commonwealth Government rather than state and territory governments, however a record $12 million has been provided to support older Queenslanders this financial year. As announced in last year s State Budget, the Government is investing $6.1 million for seniors over four years from 2016-17 to deliver the Queensland: an age-friendly community strategy. This includes $1 million per year over three years to establish Advancing Queensland: an age-friendly community grant programs. Last year s Budget also allocated $100,000 per year over four years to expand the state-wide Seniors Enquiry Line to improve services throughout Queensland, including enhancing access to specific expertise and advice on a range of issues. The 2017-18 Budget includes $900,000 per year over three years to expand elder abuse prevention services and seniors legal and support services to regional and remote areas, as well as the Gold Coast and Sunshine Coast.
The Budget also provides $250,000 per year over the next two years to address recommendations by the Advisory Taskforce on the Residential Transition for Ageing Queenslanders. NDIS and disability services A record $1.887 billion has been provided for disability services in the 2017-18 Budget, including $548.9 million to support the roll out of the NDIS in Queensland. Last month it was announced that people with disability in Ipswich, Bundaberg and Rockhampton will now receive earlier access to the NDIS. $8.3 million will be provided in 2017-18 for NDIS readiness initiatives, continuing the work of the State Government in partnering with the Commonwealth Government and service providers to prepare Queenslanders with disability for the roll out of the NDIS. This includes $4.3 million for initiatives under the NDIS Sector Development Fund. From 2019-20, when the NDIS is fully implemented, the Queensland Government will contribute $2.035 billion per year to the scheme. $14.8 million will be spent on aids, equipment and vehicle modifications for people with disability. The Budget also provides $7 million to support young people with disability leaving school and $6.7 million to support young adults with disability leaving the care of the state. The Department of Communities, Child Safety and Disability Services will also lead the implementation of a new state disability plan in 2017-18. Indigenous health The Budget includes a number of measures aimed at improving Indigenous health outcomes, including: Continuation of the Brisbane Broncos Deadly Choices Partnership, which is aimed at promoting healthy lifestyles and increasing the number of health checks undertaken by Indigenous people; The establishment of a new primary health care clinic run by the Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) Brisbane at Loganlea. ATSICHS provides a range of allied health services, including occupational therapy for adults and children; The establishment of Indigenous mental health hospital liaison services at six public hospitals; Expansion of the provision of Indigenous-specific forensic mental health services at male and female correctional facilities. Other key announcements $135.4 million to increase the delivery of digital health care across Queensland; $10 million over four years for a new Queensland Health and Medical Research Funding Program; $2 million over two years to deliver programs to increase resilience, manage stress and promote wellbeing among health professionals the Budget papers indicate that this funding only applies to medical practitioners.
***** What does the Budget mean for occupational therapy and what is OTA doing about it? Although the Queensland Government has invested a record amount in health in this year s State Budget, a large portion of this will be spent on new and existing health infrastructure. As always, OTA will lobby to ensure that the Government invests in primary and preventative health in addition to infrastructure upgrades, as this is key to keeping people out of hospital and easing pressure on hospital emergency departments. OTA believes that engaging with the Primary Health Networks (PHNs) is key to promoting the role of occupational therapists in primary health care and chronic disease management. OTA s Primary Health Project Officer, Sharon Oxenbridge, is linked in with representatives from every PHN and is in the process of preparing her final report, which will include an action plan for OTA. Sharon is also Manager Strategy & Governance for the NT/QLD Divisions of OTA. An overview of the project will be presented at the OTA National Conference next month and the final report will be made available on the OTA website. OTA will look to continue building these relationships with the PHNs to highlight the value-add and cost-effectiveness of occupational therapy services. We encourage members in Queensland to explore opportunities to get involved with their local PHN by subscribing to newsletters and monitoring any consultation opportunities. Members are encouraged to explore any projects that each PHN is working on that may include opportunities for OT involvement. The Queensland Division section of the OTA website includes links to PHN resources and publications: https://www.otaus.com.au/divisions/qld. This year s Budget provides $2 million over two years to develop educational programs to increase resilience among health professionals and equip them with coping skills. While this investment is welcomed, the Budget papers indicate that this funding only applies to medical practitioners. It is disappointing that similar programs will not be developed for allied health professionals, particularly new graduates who require support during the early stages of their career. OTA welcomes the Queensland Government s record investment of $1.887 billion in disability services. It is pleasing to note that people with disability in Ipswich, Bundaberg and Rockhampton will now be able to access the scheme earlier. Another welcome investment is the $8.3 million that has been provided for NDIS readiness initiatives over the next year. OTA hopes that this will include initiatives to support allied health professionals to transition to the scheme. The roll out of the NDIS in rural and remote parts of Queensland will no doubt pose significant challenges. OTA highlighted the need for occupational therapists to travel considerable distances to consult with clients in their own environment in our submission to the 2017 NDIS Price Review. We were recently advised that the NDIA has commissioned an Independent Pricing Review which will involve additional stakeholder consultation. Last year OTA commissioned a project to examine issues affecting occupational therapists in each NDIS launch site. OTA s NDIS National Reference Group will be meeting in the coming days to discuss the outcomes of this project and proposed next steps. Members have consistently highlighted the
value of allied health/ot-specific training for current and prospective NDIS providers, and OTA is considering how this can be provided to members via a series of webinars. The Queensland NDIS Special Interest Group meets bimonthly. Any member in Queensland who works in the NDIS can participate in these meetings. The co-convenors of this group also represent Queensland on the NDIS National Reference Group. The various Budget measures aimed at improving Indigenous health are also welcomed. The Queensland Divisional Council is currently considering a proposal from Children s Health Queensland Hospital and Health Service regarding future collaboration around the Deadly Ears Program to increase awareness of otitis media in the occupational therapy community via CPD and lobbying, and to promote national occupational therapy best practice for Aboriginal and Torres Strait Islander ear health. Conclusion The minority Palaszczuk Government has used its pre-election budget to position itself for a poll at which it will seek power in its own right. Almost all of its substantial infrastructure spend in the regions will be in the state s north, in marginal seats it must hold if this aim is to be realised. While the government s additional investment in health, disability and ageing is welcome, it pales into insignificance when seen alongside the rivers of gold flowing north. Please direct any enquiries about measures announced in the 2017 QLD Budget to: Sharon Oxenbridge, Manager Strategy & Governance NT/QLD, via mgr.ntqld@otaus.com.au.